Cryptococcal meningitis is a central nervous system infection caused by cryptococcal invasion of meninges and (or) brain parenchyma. It is characterized by severe intracranial hypertension and brain parenchyma damage. This opportunistic infection commonly occurs among HIV infected individuals, organ transplant recipients, and other immunosuppressive situations, and otherwise immunologically normal hosts. The global burden of human immunodeficiency virus/acquired immunodeficiency syndrome has declined over the years, but cryptococcal meningitis still has a high morbidity and mortality. The risk groups, clinical presentation, imaging characteristics, diagnostic criteria and therapeutic issues were reviewed in this article.

Hypervirulent Klebsiella pneumoniae (HvKP) is a new variant of Klebsiella pneumoniae. It is characterized by strong virulence and easy dissemination. It mainly causes liver abscess with multiple invasive infections, including eye, lung and central nervous system, with a high fatality rate. A case of severe intracranial infection caused by HvKP was reported. The patient was a 44-year-old formerly healthy man. He had acute onset of fever, headache, and disturbance of consciousness, which rapidly progressed to intracranial hypertension and respiratory failure. Cerebrospinal fluid examination suggested purulent infection, and bacterial culture suggested Klebsiella pneumoniae, which was sensitive to other commonly used antibiotics except ampicillin. Brain magnetic resonance imaging showed multiple abnormal signals in bilateral frontal, parietal and temporal lobes, right centrum semiovale, bilateral corona radiata, basal ganglia, thalamus and insula, as well as enhancement of meningeal and ependymal membrane, and swelling of brain tissue. During hospitalization, the patient developed a blood stream infection of pan-drug-resistant Klebsiella pneumoniae and was in critical condition. After aggressive treatment, the patient was cured and discharged from the hospital. After half a year follow-up, his prognosis was good and his social function was restored. The clinical data, diagnosis and treatment of the patient were reported and the literature was reviewed to provide clinical reference for the disease.

The development of new biomarkers or therapeutic targets for cancer immunotherapies requires deep under-standing of T cells. To date, the complete landscape and systematic characterization of long noncoding RNAs (lncRNAs) in T cells in cancer immunity are lacking. Here, by systematically analyzing full-length single-cell RNA sequencing (scRNA-seq) data of more than 20,000 libraries of T cells across three cancer types, we provided the first comprehensive catalog and the functional repertoires of lncRNAs in human T cells. Specifically, we developed a custom pipeline for de novo transcriptome assembly and obtained a novel lncRNA catalog containing 9433 genes. This increased the number of current human lncRNA catalog by 16％and nearly doubled the number of lncRNAs expressed in T cells. We found that a portion of expressed genes in single T cells were lncRNAs which had been overlooked by the majority of previous studies. Based on metacell maps constructed by the MetaCell algorithm that partitions scRNA-seq datasets into disjointed and homogenous groups of cells (metacells), 154 signature lncRNA genes were identified. They were associated with effector, exhausted, and regulatory T cell states. Moreover, 84 of them were functionally annotated based on the co-expression networks, indicating that lncRNAs might broadly participate in the regulation of T cell functions. Our findings provide a new point of view and resource for investigating the mechanisms of T cell regulation in cancer immunity as well as for novel cancer-immune biomarker development and cancer immunotherapies.

BACKGROUND: Malignant plural effusion (MPE) is one of the most common specimen for liquid biopsy gene detection. This study aims to explore a method for isolating tumor cells from large volume of MPE and evaluate its efficacy and application prospect in gene detection. METHODS: Pleural effusions (>500 mL) from 20 advanced lung cancer patients were obtained by effusion drainage and used to isolate tumor cells with cell separation media Percoll and Ficoll. Cell number and purity were calculated. DNA was extracted from the supernatant (etDNA), total cells and isolated tumor cells of pleural effusion (ETC-DNA) to detect the mutation of tumor-related genes by next-generation sequencing. RESULTS: The median number of cells isolated from malignant pleural effusion was 8.50×10⁴ (interquel range: 9.25×10³-3.75×10⁵), 85.50%±5.80% of the cells were identified as tumor cells. The detection rates of epidermal growth factor receptor (EGFR) gene mutation of etDNA, total cell DNA and ETC-DNA were 70.00%, 50.00% and 70.00%, reseparately, while the median EGFR mutation abundance in 3 components was 16.05% (4.78%-43.06%), 1.09% (0.00%-2.39%), and 33.02% (18.50%-76.70%), respectively. ETC-DNA had good consistency with tissue DNA (P>0.999, kappa=1.000) and etDNA (P>0.999, kappa=1.000). ETC-DNA inclined to have higher EGFR mutation than etDNA, but the result was not statistically significant. CONCLUSIONS Our method can isolate large amount of tumor cells from a large volume of malignant pleural effusion with high purity. Using ETC-DNA as specimen improves the efficacy of gene detection, thus is worth further study.

Radiation-induced brain injury (RBI) is the most serious complication of head and neck tumor after radiotherapy. The pathogenesis of RBI is complicated, and the clinical course is irreversible, while no effective treatment available. The activation of glial cells is one of the main theories of RBI, and the prevention and treatment of RBI by targeting glial cells is the focus of current research. As a post-transcriptional regulatory factor, microRNA (miRNA) has been confirmed to be involved in regulatingglial cell radiosensitivity, inflammation type transformation, autophagy, exosomatic, long non-coding RNA (lncRNA), circular RNA (circRNA) and other related pathways, thereby mediating the occurrence and development of cascade reaction of inflammatory injury and neurological function repair of central nervous system (CNS) disease. Therefore, the establishment of miRNA - glial regulatory network may provide a new strategy for the prevention and treatment of RBI.

Objective To explore the clinical features, cytogenetic and molecular genetics characteristics of trisomy 12 p in neonates. Method The clinical data were reviewed in a neonate with trisomy 12 p confirmed by routine G-banding chromosome karyotype analysis, high throughput sequencing chromosome copy number variation analysis (CNV) and lymphocyte interphase fluorescence in situ hybridization (FISH) . Results The chromosome karyotype in peripheral blood of the neonate was 47, XX, +mar, and the karyotypes of her parents were normal. CNV detected a regional duplication of 12 p13.33-p11.1 (160001-34860000) with a fragment size of 34.7 Mb. Peripheral blood lymphocyte interphase FISH showed that there were 3 signals in the short arm of chromosome 12 in all interphase nuclei of the neonate, and no chimera existed. It was finally confirmed to be trisomy 12 p. Conclusion The combination of clinical features, peripheral blood karyotype analysis, CNV and FISH techniques can effectively confirm the diaganosis of trisomy 12 p.

Objective To investigate the relationship between 9p21 single nucleotide polymorphism (SNP) and myocardial infarction(MI) in Yunnan Yi nationality. Methods One hundred and ten patients with MI and 110 controls were enrolled. DNA sequencing was used to detect 9p21 gene locus and SNP typing and analysis. Results Hardy-Weinberg equilibrium was found in 9 sites of chromosome 9p21 in myocardial infarction group and control group.The frequency of rs1333049 GG genotype was 30.91% and 18.18% in case group and control group respectively, G The frequencies of rs2383206 GG genotype were 31.82% and 18.18%, respectively, and the frequencies of G allele were 55.3% and 41.1%, respectively. There were significant differences between the two groups 58.3% and 44.9%, The difference between the two groups was statistically significant(P<0.05). Conclusion This study demonstrates an association of rs1333049 polymorphism locus on chromosome 9p21 with risk for MI in in Yunnan Yi nationality.

Objective To study the predictive validity of fidgety general movement assessment in pre-term twins and multiplets for motor development outcomes.Methods A total of 53 pre-term twins or multiplets delivered between July 2011 and February 2016 participated in this study.They were assessed using a general movements (GM) assessment and participated in the follow-up program until one year old.The motor development outcomes of the infants at one year old were determined according to clinical diagnoses and the Peabody developmental motor scale number two (PDMS-2) evaluation.The predictive validity of fidgety general movement assessment for motor development outcomes was calculated against the standard motor development of infants at one year old.Results There were 53 twins or multiplets who accepted the GM assessment of fidgety movement period.Of these,43 were assessed as normal (NF) and ten (19％) as lacking a normal level of fidgety movement (F-).All 53 cases were followed-up for the motor development outcome.Forty-three cases (81.1％) were assessed as normal at one year old,while ten (18.9％) were assessed as abnormal.All ten had cerebral palsy,and no motor development retardation was found.The predictive value of F-for cerebral palsy was 90.0％ in terms of sensitivity,97.7％ in terms of specificity,90.0％ in positive predictive value,and 97.7％ in terms of negative predictive value.Conclusions Among pre-term twins or multiplets,the fidgety general movement assessment can be a useful early indicator of motor development difficulties.

Short stature refers to the individual of the same race,gender and age,whose height is lower than the average height for about 2 standard deviations or under the 3rd percentile in the similar living environment.Its etiology mainly includes growth hormone deficiency,hypothyroidism,idiopathic short stature,Turner syndrome and so on.Short stature can be treated in childhood with recombinant human growth hormone (rhGH).Clinical evidence suggests that doctors should pay attention to thyroid hormone levels before and after rhGH therapy,so that they can offer thyroxine timely and maintain normal thyroid function for the children with hypothyroidism,which can improve the efficacy of rhGH in children with short stature.

One hundred fifty-three patients with hypoxia of both sexes,underwent hip arthroplasty from January 2012 to January 2014,aged 65-97 yr,weighing 41-80 kg,living in areas at altitude above 1800 m,of American Society of Anesthesiologists physical status Ⅱ-Ⅵ,were selected.The hemoglobin (Hb) at 3-4 days after operation was collected,and the patients were divided into 3 groups depending on whether or not postoperative anemia occurred:no anemia group (Hb＞ 110 g/L);mild anemia group (90 g/L≤ Hb≤ 110 g/L);moderate anemia group (70 g/L ≤ H b＜ 90 g/L).The 36-item Short-Form Health Survey score and Harris Hip Score at 28 days after operation were collected.There was no significant difference between the three groups in the postoperative 36-item Short-Form Health Survey score and Harris Hip Score (P＞0.05).Postoperative mild and moderate anemia did not affect the short-term outcome after hip arthroplasty in elderly patients in high-altitude regions.